Provider Demographics
NPI:1538609185
Name:FAMILY CONNECTIONS COUNSELING, PC
Entity type:Organization
Organization Name:FAMILY CONNECTIONS COUNSELING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:HUGHES
Authorized Official - Last Name:TABOR, LPC
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:336-684-9951
Mailing Address - Street 1:2614 CAMBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-8804
Mailing Address - Country:US
Mailing Address - Phone:336-684-9951
Mailing Address - Fax:336-513-0554
Practice Address - Street 1:2207 DELANEY DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5263
Practice Address - Country:US
Practice Address - Phone:336-684-9951
Practice Address - Fax:336-513-0554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6630101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC23314Medicaid